GuidelineEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025
Stop the bleed " - Prehospital bleeding control in patients with multiple and/or severe injuries - A systematic review and clinical practice guideline - A systematic review and clinical practice guideline.
Guideline in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Tourniquet use in different emergency medicine professional groups, results from a regional cross-sectional online survey.BMC emergency medicine · 2026Article
- RECOVER Guidelines: First Aid in Dogs and Cats. Evidence and Knowledge Gap Analysis With Treatment Recommendations.Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) · 2026Article
- Under pressure - a sensor-based analysis of simulated prehospital pressure dressing application for hemorrhage management.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Observational
- Chinese expert consensus on the prehospital management of major trauma.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2026Article
- Are multiple limb injuries in severely injured patients negligible? Evaluation of progression and outcome using a new scoring system for extremity injury: the Extremity Severity Score (ESS).European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Implementation status of European guidelines on trauma management of prehospital bleeding control: a national survey in Austria.BMC emergency medicine · 2025Article
- Applications of Hydrogels in Emergency Therapy.Gels (Basel, Switzerland) · 2025Review
- Obesity: a challenge for emergency medical teams-a narrative review.Frontiers in public health · 2025Review
- Application of key link nursing based on feedforward control theory in the emergency rescue of multiple trauma patients.Frontiers in public health · 2025Article
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeOur aim was to develop new evidence-based and consensus-based recommendations for bleeding control in patients with multiple and/or severe injuries in the prehospital setting. This guideline topic is part of the 2022 update of the German Guideline on the Treatment of Patients with Multiple and/or Severe Injuries.
methodsMEDLINE and Embase were systematically searched until June 2021. Further literature reports were obtained from clinical experts. Randomised controlled trials, prospective cohort studies, and comparative registry studies were included if they compared interventions for bleeding control in the prehospital setting using manual pressure, haemostatic agents, tourniquets, pelvic stabilisation, or traction splints in patients with multiple and/or severe injuries. We considered patient-relevant clinical outcomes such as mortality and bleeding control. Transfusion requirements and haemodynamic stability were surrogate outcomes. Risk of bias was assessed using NICE 2012 checklists. The evidence was synthesised narratively, and expert consensus was used to develop recommendations and determine their strength.
resultsFifteen studies were identified. Interventions covered were pelvic binders (n = 4 studies), pressure dressings (n = 1), tourniquets (n = 6), traction splints (n = 1), haemostatic agents (n = 3), and nasal balloon catheters (n = 1). Fourteen new recommendations were developed. All achieved strong consensus.
conclusionBleeding control is the basic objective of treatment. This can be easily justified based on empirical evidence. There is, however, a lack of reliable and high-quality studies that assess and compare methods for bleeding control in patients with multiple and/or severe injuries. The guideline provides reasonable and practical recommendations (although mostly with a low grade of recommendation) and also reveals several open research questions that can hopefully be answered when the guideline is revised again.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.